Holistic health care

[Dale]

G'day Mike,
Perhaps the justification for using that particular herbs was due to it's ability to target the specific bacteria in question. But, as Paddy pointed out, if it did not fit the TCM pattern it should not have been used, at least not within a TCM framework.

I think it is more beneficial to us, as TCM practitioners, to look closely at why that herb works to treat stomach ulcers within the TCM system. Otherwise we are just practising an unrefined version of western medicine, without appropriate training to support it.

It is always a bit of an excitement when scientific theory supports some aspect of TCM, but that should not mean that we abandon the TCM theoretical framework in favour of this scientific approach. To do so would, in my opinion, demonstrate a lack of confidence in the effectiveness of the TCM system. I have the upmost respect for those testing our modality through the scientific method and feel that this does a great service to the respect TCM has within the scientific community, but this should not change the way TCM is practised.
It is with great interest that I read about the chemistry of different herbs, but this is not the way in which I am trained to use them, so it does not go beyond being a point of interest. Perhaps it was as a point of interest to students that this practitioner pointed out the scientific properties of this herb, or to explain how scientific evidence supports the use of this herb.

I am not trying to discredit the western medical view, I work in a hospital and see it working every day, but I think there are others, far more qualified than us, in that field who should be using it. Naturopaths have been using their own "holistic" system, based on western science, for a long time with impressive results. However that is the system in which they are trained and in which their medical system is based. For us to try and practise in such a way would not be doing justice to either modality. I think it is best practise to use western theory as a point of interest, or as confirmation of the appropriateness of a treatment but not as a primary focus. The support Science offers us is a great tool but if it can't be explained using TCM logic then it is not the appropriate avenue for us to take.

NB: It is interesting to note that Chinese educated TCM practitioners are actually trained as medical doctors prior to learning TCM so it would be hard for them, and irresponsible of them, to totally abandon this aspect of their training when providing a holistic treatment.

Just my thoughts,


Respectfully,
Dale Elsdon

[Carole Rogers]

I really admire the answers to the question posed - they are great. What I was hoping to get back - and did in many instances - was the idea that 'holistic' means much more than just a unity of mind and body. It does mean that everything influences the patient so that you really can't put a needle into the same patient twice - any more than you can step into the same river twice.

This in turn raises another question. The patient is a product of their hereditory influences and their environment, including moment to moment influences. If we then consider what herbs might be effective in treating the ills of that patient then herbs that are the product of the same environment come to mind. This in turn suggest that while the Australian aborigine is going to benefit from the traditional herbs of his or her culture, the anglo-saxon transplants - that are many of us - might be better served by a combination of European herbal medicine and local herbs. In turn Philippinos in this country may do better with their traditional herbal remedies, while the Chinese have, of course, their traditional herbal medicine. Herbs have been tested and shown that the same species have different levels of active ingredients when grown in different parts of the world. Take for example the differing properties of the various forms of ginseng available.

I am not suggesting that Chinese herbs don't work - it is obvious that they do - but there also seem to be some pretty awful side effects that Europeans often experience. Perhaps therefore the herbal system from our own cultural background is better suited to our needs. This is just a thought that I've had over the years and wonder if anyone else has any ideas about this possibility.

Acupuncture works on the energy of the patient - nothing is added or taken away. So I see no problem here.

By the way Dale - although western medical practitioners in China do study TCM at a post graduate level if they wish, not all Chinese trained TCM practitioners hold a western medical degree. In most of the Chinese TCM universities the undergraduate program is similar to our undergraduate training - although it is longer because they include some general studies and a second language. The majority of Chinese trained TCM practitioners therefore do not hold a western medical degree.

Cheers,

Carole

[Dale]

Ooops my apologies,
Thanks for the correction Carole. My experience in China was in a hospital so the Doctors there were all western trained first. I did ask about undergraduate programs and it was my impression that they didn't exist, guess I can put that down to the language barrier.

Thanks Carole.

[Dale]

I have heard a few horror stories about westerners, and chinese, taking Chinese herbal medicines and having shocking side effects. However, in all the cases I have heard of this can be put down to either self prescription, overdosing, or problems with the herbs themselves. These problems include the use of chemicals and pesticides, the presence of heavy metals, or the sustitution, or poor identifyication, of herbs. Unfortunately this is a significant issue with imported herbs and one which all practitioners should be mindful of.

It is a common thought pattern in western culture that if a little bit of something helps a little bit then a truck load of it must help a truck load! Substance abuse is substance abuse regardless of what that substance is, and self prescription is never a good idea, even if the latest "Cosmo" says take ginseng for this or Dang Gui for that!

Also the cultural conditioning of many westerners may result in a reluctancy to discuss their bowel habits or libido when they come for treatment for a headache, particularly if the relevance of such enquiry is not made obvious. This could make accurate diagnosis difficult and the risk of a less than suitable prescription higher.

As for acupuncture I have had people ask me if it is true that acupuncture doesn't work on people of african origin! Now to me the theory should work and should be applied universally but, given the nature of this discussion, it is interesting to acknowledge the differences anatomically between people from the african continent and those from the asian continent, also those from europe, india or the pacific islands for that matter.
If we are going to consider how the the hereditary influnces of a certain culture affects how these people will react to herbal medicine then is it not then reasonable to consider how people might react differently to stimulation by acupuncture? Or perhaps how point location may be affected by an individuals hereditary makeup? Or perhaps channel pathways or interactions could vary between people of different hereditary backgrounds?

Personally I think that if TCM is practised in a truly holistic manner then these factors become apparent and are dealt with in treatment. Theoretically each patient, regardless of their hereditary or cultural origins, should be treated according to their own individual makeup and circumstances. I think, and I may be wrong, that if the principals of TCM are adhered to, and quality control is maintained, then hereditary factors are considered and there should be no negative side effects of TCM treatment.



Respecfully,
Dale Elsdon

[Cam]

Yes,Yes,Yes,
Dale you are correct about your truck load comments.

I found it hard to believe that after four years of training someone in "balance" the fourth year practitioners would want to use every point they had learnt on the first treatments. "just to be sure". 60 needle prescriptions are sure to get one result. You'll never see that patient again

I studied western herbs but kicked out a fellow herbalist out of my clinic after she would constantly and in my opinion dangerously overprescribe and overdose all her patients. It was not what Dorothy Hall had taught us to do. Dorothy Hall had a good appreciation of balanced approach to Tx.

I chose to study Western Herbs over Chinese Herbs Back in the early 80s Chinese Herbs were often smuggled into Oz and were of unknown origin or type. Even as a western herbalist I got all my herbs in "brown bottles" from reputable suppliers. They had checked for residues and content and quantified active ingredients in Hypericum etc. I'd prefer not to get a patient better than kill them in the attempt.

With some Chinese herbs the effective dosage and lethal dose are not that different eg. "Aconitum Napellus" I would not use or prescribe or take myself in a mad fit. I was horrified by practitioners of Medicine, Western Doctors and Western Herbalists who had told me they wouldn't take the Txs they prescribed if they were ill . In 18yrs of practice I never gave a patient something I wouldn't have taken myself if I had their problem.

Regards
Cam

[michael]

Thanks Dale for your earlier reply, I hadn't considered that the herb that I mentioned earlier used in ST ulcer may have been mentioned by the practitioner as a point of interest - a consideration which probably nullifies what I had said.

To return to the main topic, I think the holism of TCM comes through the world view it creates. All things can be explained in terms of Yin, Yang, Qi, five phase etc, so that as practitioners we can take into account all things that are presented to us. With this world view it is even possible to explain non-TCM things in TCM terms; eg antiinflammatory medicines can be considered "cold" in nature, using TCM herb language (not that you would include asprin in a formula). So when it comes to treatment, even taking into account the genetic / geographical differences, these differences should present as factors we could rationalise with TCM (you might theorise that eskimos have more Yang constitutions to cope with the cold for example). Holism in TCM is in the connections we are able to observe and explain within the individual and between the individaul and everything else. Which is why we have clear explinations for things that western Drs wouldn't, eg why being out in the wind would cause a headache or stiff neck. So TCM is holistic because it links everything together. Thats how I see it anyway. I feel like I'm back in first year.

The problem with my description of holism though is that it is exclusive to TCM. So although other modalities would be considered holistic (like naturopathy), it would be a distinct system, incompatible in its practice, to TCM. Any thoughts?

Another Question: Are Western herbs as incompatible with TCM as antibiotics? TCM has a world view which decribes all things as Yin Yang, Five Phase ,etc. So does using western herbs fit into this system if western herbs are based on western science? Is Naturopathic holism distinct from TCM holism?